| NPI | 1396013439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 10077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 10696) |
| Enumeration Date | 2011-12-04 |
| Last Update Date | 2011-12-04 |