| NPI | 1700467750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0024678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H0102936) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2025-06-26 |