| NPI | 1275732364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD18801) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD18801) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2021-10-22 |