| NPI | 1548208796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 5901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD9836) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-03-17 |