| NPI | 1144261355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 021496) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 12252) |
| 207R00000X Internal Medicine (Licence: FL ME117141) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2017-02-23 |