| NPI | 1265460646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 25362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 45039) |
| 207R00000X Internal Medicine (Licence: MN 102704) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-08-04 |