| NPI | 1942361076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0013284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD427714) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2019-09-19 |