| NPI | 1154362325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME66988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME66988) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-05-02 |