| NPI | 1659323350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD425173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE CI-0010214) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-01-07 |