| NPI | 1457326639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01059733A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME81976) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-08-24 |