| NPI | 1841394954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0015765) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD13585) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2009-07-23 |