| NPI | 1598992208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 241266) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 36450) |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2018-06-21 |