| NPI | 1689622938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2012023084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-32632) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-06-24 |