| NPI | 1568410363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 30590) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 057088) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2009-03-20 |