| NPI | 1033344643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME119644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN13798) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2017-01-13 |