| NPI | 1699745943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS 12015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C2-0005315) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2016-01-08 |