| NPI | 1376619726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 16447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN md0000021257) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2009-05-28 |