| NPI | 1407905292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 6924) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 168964-1205) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-04-24 |