| NPI | 1144584434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A139071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.060754) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2016-01-12 |