| NPI | 1992906911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0067145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME98826) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2008-08-13 |