| NPI | 1316172885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101253476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P24012) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2014-04-03 |