| NPI | 1831370345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0005151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD25658) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2008-02-13 |