| NPI | 1386097202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0029063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0106893) |
| 207R00000X Internal Medicine (Licence: PA MD467761) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2026-07-22 |