| NPI | 1134380298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A113491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME152459) |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2025-11-14 |