| NPI | 1477515492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 6453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 006453) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-02-06 |