| NPI | 1861653818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101251583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D82586) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2017-03-23 |