| NPI | 1538457437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2013022101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD p25498) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2015-04-15 |