| NPI | 1932268273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 203695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 41146) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2010-09-02 |