| NPI | 1134359110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-04276) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL0658) |
| 207R00000X Internal Medicine (Licence: IA 4276) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2014-03-20 |