| NPI | 1396057618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 22537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2353) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2015-05-12 |