| NPI | 1932248937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2006-0186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 2004-0246) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-05-09 |