| NPI | 1205898483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 009300160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC TL29367) |
| 207R00000X Internal Medicine (Licence: VA 0101231028) | |
| 207R00000X Internal Medicine (Licence: MD D0061172) | |
| 207R00000X Internal Medicine (Licence: GA 055244) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2014-12-10 |