| NPI | 1063531259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D51024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0051024) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2013-12-31 |