| NPI | 1427085893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 304038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200600847) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2017-01-31 |