| NPI | 1093795551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.205740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 12832) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2013-02-22 |