| NPI | 1275562076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 15416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R4F46) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2012-11-01 |