| NPI | 1326017856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME121819) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN ME14068) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2015-11-25 |