| NPI | 1033160189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01065234A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 53139) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2011-07-22 |