| NPI | 1841250461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 44686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 230317) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2014-05-21 |