| NPI | 1194810481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 23431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME111390) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2016-04-26 |