| NPI | 1952319238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 31289) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 80921) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-07-29 |