| NPI | 1295228856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH EL11158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME DO3226) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-03-07 |