| NPI | 1306324728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME145566) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD23913) |
| 207R00000X Internal Medicine (Licence: PR 21717) | |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2021-11-16 |