NPI | 1730476128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0011252) |
Additional Taxonomies | 208D00000X General Practice (Licence: PA OT014355) |
Enumeration Date | 2011-07-06 |
Last Update Date | 2015-04-08 |