| NPI | 1255669826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME111971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A120745) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2024-07-18 |