| NPI | 1184069858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 1488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R2228) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2016-07-27 |