| NPI | 1043249949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 22957) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME160461) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-08-07 |