| NPI | 1881799278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD17471) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229934) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2014-09-04 |