| NPI | 1699883447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M11489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD156651) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-11-28 |