| NPI | 1326023730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0055089) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME55089) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-07-22 |