| NPI | 1679525133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME93443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00026229) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-06-24 |