| NPI | 1184685612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01059123A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LR23227) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2009-01-14 |