| NPI | 1437415676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0012801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101258274) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2018-08-31 |