| NPI | 1316925449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 2084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 1786) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2017-07-20 |