| NPI | 1407929698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0042752) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD17299) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-12-06 |