| NPI | 1295990588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0009038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0079914) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2025-07-30 |