| NPI | 1013933712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 98963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-7515) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-08-12 |