| NPI | 1093906117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 242684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-231926) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2018-03-17 |