| NPI | 1841281730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101239261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 15631) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2013-01-31 |