| NPI | 1679515431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD40682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 40682) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-08-07 |