| NPI | 1356438170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME137146) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 335283) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-09-25 |