| NPI | 1669684684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 41883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 77196) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-05-06 |