| NPI | 1538481197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 077221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 205684) |
| 207R00000X Internal Medicine (Licence: IL 036129944) | |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2018-07-30 |