| NPI | 1356309769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 29047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 1750) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2017-11-01 |