| NPI | 1346204062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 48016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME94738) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2017-01-30 |