| NPI | 1346317005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD167344) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D50860) |
| 207R00000X Internal Medicine (Licence: WY 8428A) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-10-24 |