| NPI | 1932319860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 16635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-7851) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-11-09 |