| NPI | 1093027443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 25793) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0012863) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2024-06-18 |