| NPI | 1932192994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 026225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 021372) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2018-04-12 |