| NPI | 1275593774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME132019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 151943) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2024-01-19 |