| NPI | 1649497702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 23717) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-08-08 |