| NPI | 1962659599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 103022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 017211) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2011-02-10 |