| NPI | 1295992311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0076948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC DO034287) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2013-12-12 |