| NPI | 1255467684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MS20220) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD20220) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-08-23 |