| NPI | 1013009547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 20258) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 5357) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-06-02 |