| NPI | 1437362456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 31331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301089530) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-12-10 |