| NPI | 1144487521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 65670) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 232191) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2016-10-19 |