| NPI | 1417958919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-1934) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR E1934) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2019-12-16 |