| NPI | 1851552830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0012283) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 106513) |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2017-09-20 |