| NPI | 1326355561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0012466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS018824) |
| 207R00000X Internal Medicine (Licence: NY 264826-1) | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2023-07-19 |