| NPI | 1144203118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 40225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 42085) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2011-01-04 |