| NPI | 1184862989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME158376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A112265) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2023-03-09 |