| NPI | 1689844268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2010041792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.052431) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2011-10-19 |