| NPI | 1932411733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 8886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6387) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2015-12-22 |