| NPI | 1528106309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID M-9630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M9630) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2016-05-13 |