| NPI | 1265581078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0046374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD20936) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2010-05-11 |