| NPI | 1174695266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0075386) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD30607) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2014-09-20 |