| NPI | 1538206230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME62837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 26296) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |