| NPI | 1831150531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 14058) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MS 14058) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: MS 14058) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2015-10-07 |