| NPI | 1346396801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME125934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 156996-1) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-05-04 |