| NPI | 1467646943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A121676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD19121) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2017-10-10 |