| NPI | 1033171277 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME66835) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 66835) | 
| Enumeration Date | 2006-04-04 | 
| Last Update Date | 2010-01-21 |