| NPI | 1336222017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C10005656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0054584) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2015-10-27 |