| NPI | 1992932438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 249691) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-240147) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2012-01-24 |