| NPI | 1982871075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 17168) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 243734) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2015-11-11 |