| NPI | 1699888081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 3918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7598) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-07-24 |