| NPI | 1467445338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME9938) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 007898) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2017-03-13 |