| NPI | 1144232281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 069265) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 127213) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2018-06-27 |