| NPI | 1205157500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0070148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 33910) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |