| NPI | 1346207727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 018612) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 018612) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2014-10-16 |