| NPI | 1326069857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 14143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME116549) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-10-11 |