| NPI | 1952329831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 47343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID TL3785) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-06-18 |