| NPI | 1588831648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O1253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 8547) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2019-04-17 |