| NPI | 1336168707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 15160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 36000) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-11-03 |