| NPI | 1518006527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2007-0115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 12659) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-09-12 |