| NPI | 1548486053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-5577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5296) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-12-18 |