| NPI | 1932153525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME38849) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME38849) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2015-03-19 |