| NPI | 1134337892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME118701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD12866) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2021-11-22 |