| NPI | 1396700316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01032568A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 21559) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2014-10-29 |