| NPI | 1841377116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 51121-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 10983) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-08-04 |