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 |