| NPI | 1134143092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 37974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223943) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2013-07-08 |