| NPI | 1831404367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD165439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096411) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2014-09-11 |