| NPI | 1346469368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 2406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX G 6774) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2012-08-31 |