| NPI | 1437267655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 7540A) |
| 207R00000X Internal Medicine (Licence: PA OS004011L) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2018-02-15 |