| NPI | 1427039973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R7046) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-23716) |
| 207L00000X Anesthesiology (Licence: MO R7046) | |
| 207R00000X Internal Medicine (Licence: KS 04-23716) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2020-03-14 |