| NPI | 1255314365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME25700) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME25700) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-06-29 |