| NPI | 1669440194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0007515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0102633) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2025-02-24 |