| NPI | 1134232697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 37491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7612) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2018-09-05 |