| NPI | 1740208073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 9458) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME65433) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-05-26 |