| NPI | 1275532087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301039381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI SY03981) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2016-12-27 |