| NPI | 1548399413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2007-00432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 35877) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-01-27 |