| NPI | 1528442746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.40754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0012798) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2020-09-02 |