| NPI | 1083775126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0026607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD13637) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-03-04 |