| NPI | 1902036965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0026264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0082783) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2023-10-20 |