| NPI | 1114948114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0053711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD31879) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-06-16 |