| NPI | 1710478987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0024162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN26510) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2021-08-30 |