| NPI | 1982684924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 30853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 30853) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2016-12-19 |