| NPI | 1295945996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301084045) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME150730) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-02-29 |