| NPI | 1497987168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 65155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01071216A) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2016-08-10 |