| NPI | 1598027468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 17374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH T-0819) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2015-12-28 |