| NPI | 1467566836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 21978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 16280) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-12-17 |