| NPI | 1346289758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 11140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-27165) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2022-02-22 |