| NPI | 1144667817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-13197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M13197) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2016-08-18 |