| NPI | 1285862946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD 16444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-5666) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-05-09 |