| NPI | 1285627265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 41259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 049171) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2017-11-02 |