| NPI | 1427148386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 34847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0057892) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-06-05 |