| NPI | 1093027120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-04612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R9030) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2015-02-11 |