| NPI | 1447332424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 47019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-098583) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2011-09-09 |