| NPI | 1659752517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0026293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0101012) |
| 207R00000X Internal Medicine (Licence: PA MD465404) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-07-12 |