| NPI | 1891971842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101243506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11012674A) |
| Enumeration Date | 2008-01-20 |
| Last Update Date | 2011-03-16 |