| NPI | 1437163326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101054192) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101054192) |
| 207R00000X Internal Medicine (Licence: ND LT 13371) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2014-10-24 |