| NPI | 1922095348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 18734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 228646) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2019-02-06 |