| NPI | 1982629234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 26171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 30470) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |