| NPI | 1881905370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-41575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6336) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2014-10-13 |