| NPI | 1144267444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01035185A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036069355) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2009-12-29 |