| NPI | 1043262041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD126158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 016903) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-07-30 |