| NPI | 1316914120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-27378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23365) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2007-07-09 |