| NPI | 1801011598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101248053) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME98304) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-08-27 |