| NPI | 1841216827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 21155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 043987) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-06-06 |