| NPI | 1033670914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME163770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2022-00792) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-09-19 |