| NPI | 1447353743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 6017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 5263105-1205) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2015-09-17 |