| NPI | 1497798342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0074531) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01047666) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-11-19 |