| NPI | 1689908253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 45064) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2016-04-19 |