| NPI | 1386837342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 238378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD436247) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2015-03-12 |