| NPI | 1619196938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 31524) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AL 31524) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-10-16 |