| NPI | 1952390189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-44851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME84354) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2019-06-13 |