| NPI | 1346212958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 1718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 18103) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2008-10-03 |