| NPI | 1295728368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 26061) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-26524) |
| 207R00000X Internal Medicine (Licence: MO 108755) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2016-09-29 |