| NPI | 1235178831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 336.059377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.098432) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-01-29 |