| NPI | 1912583386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0028047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0104144) |
| 208000000X Pediatrics (Licence: DE C1-0028047) | |
| 208000000X Pediatrics (Licence: MD D0104144) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-06-26 |