| NPI | 1841465655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 250384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD437538) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-01-10 |