| NPI | 1942490206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME119910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD036765) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2014-07-29 |