| NPI | 1467545236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0071351) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-33556) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-12-26 |