| NPI | 1497953954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-7366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R8328) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2013-04-04 |