| NPI | 1184638694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D23783) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD9142) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-06-16 |