| NPI | 1346355757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 039710) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 20683) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-10-23 |