| NPI | 1861409153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 20694) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 020694) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-02-07 |