| NPI | 1356347215 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-31842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 32631-020) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KS 04-31842) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-08-23 |