| NPI | 1295797223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 63733) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0063087) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-02-27 |