| NPI | 1871506311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 233668) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-2586) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-06-24 |