| NPI | 1356332662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01038928A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01038928) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2011-12-14 |