| NPI | 1336323088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD184809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD202269) |
| 207R00000X Internal Medicine (Licence: LA MD.202269) | |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2018-03-12 |