| NPI | 1659480283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 254493) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R4F74) |
| 207R00000X Internal Medicine (Licence: MO R4F74) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2013-06-11 |