| NPI | 1467434274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2010-00239) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 35479) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2019-04-15 |