| NPI | 1649611898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3637) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2016-07-01 |