| NPI | 1629235015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: DC MD041048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P-22587) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2013-02-01 |