| 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 |