| NPI | 1841200821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI MK027675) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME83376) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-05-12 |