| NPI | 1841263241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 55832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.046096) |
| 207R00000X Internal Medicine (Licence: IN 01027001A) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2007-07-08 |