| NPI | 1780742528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 26629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 26043) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2014-09-22 |