| NPI | 1730532656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0027902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211346) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2025-04-24 |