| NPI | 1144497009 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD151063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR LL17373) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2012-10-03 |