| NPI | 1326150038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 43157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301051654) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-09-30 |