| NPI | 1770771297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-7040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P22258) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2011-06-23 |