| NPI | 1497723696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01050185A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 20515) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2016-03-28 |