| NPI | 1366445389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 11334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 037318) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-12-26 |