| NPI | 1275507576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101265811) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 115130) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-12-18 |