| NPI | 1750591640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D52982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD30665) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-05-21 |