| NPI | 1366593709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 104864) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-24917) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2013-12-03 |