| NPI | 1578553210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: UT 10119882-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 0119882-8905) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-02-21 |