| NPI | 1851340517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0024932) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME90831) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-05-23 |