| NPI | 1093980757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC tl34041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 148953) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2011-08-17 |