| NPI | 1558523191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 44348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 68999) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2016-12-26 |