| NPI | 1336692953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-44689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267475) |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2025-02-24 |