| NPI | 1639306293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 27309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-41542) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2018-12-05 |