| NPI | 1871568824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C10009315) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D63063) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-08-24 |