| NPI | 1942350947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 63905-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 22625) |
| 207R00000X Internal Medicine (Licence: MI 4301089219) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2015-05-27 |