| NPI | 1689684177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD DOO65418) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200200430) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-10-10 |