| NPI | 1215249156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-3965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E3965) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |