| NPI | 1093779365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MDO9438) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M6155) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2009-02-04 |