| NPI | 1194785311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD9725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0032727) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-09-26 |