| NPI | 1427177690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0033656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 039937) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2010-02-03 |