| NPI | 1396857793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME43522) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 023799) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |