| NPI | 1801082508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101244284) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205955) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2012-02-02 |