| NPI | 1578759734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 3229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME EL191043) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2019-12-04 |