| NPI | 1265497366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 27416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR N-6055) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-11-06 |