| NPI | 1205817384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D13971) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0013971) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-07-30 |