| NPI | 1659537272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2016011742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 21402) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2016-10-20 |