| NPI | 1912421900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0013557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0102392) |
| 207R00000X Internal Medicine (Licence: MD P-9999) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2025-02-12 |