| NPI | 1528069598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 4212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 36497) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2018-03-20 |