| NPI | 1053422006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 1007690) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI JL007690) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-08-05 |