| NPI | 1386629350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 281923) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 2587) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2020-06-30 |