| NPI | 1316144488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A114853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 232100) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2011-04-19 |