| NPI | 1316047327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0056791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD034535) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-10-12 |