| NPI | 1235398629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 238660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME106872) |
| 207R00000X Internal Medicine (Licence: FL ME106872) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2023-09-12 |