| NPI | 1285720508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME179187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036075238) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2026-05-05 |