| NPI | 1487834172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME105678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 001827) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2010-04-22 |