| NPI | 1942267265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 045929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI 08716) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2014-08-14 |