| NPI | 1144509480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS12595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 172591) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2014-08-05 |