| NPI | 1184184285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME166273) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD480505) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-05-07 |