| NPI | 1669527156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 32421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 016438) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2018-11-28 |