| NPI | 1336336783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME104859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 725050925) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-10-29 |