| NPI | 1629451463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0012545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P31998) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2022-01-03 |