| NPI | 1134180615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 29721) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2019-10-16 |