| NPI | 1154334340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD11935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D20868) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |