| NPI | 1952411514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 54809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-115746) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-01-04 |