| NPI | 1518913524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-123415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 35288) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-02-23 |