| NPI | 1093953366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 59995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 12400) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2016-03-16 |