| NPI | 1396836706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME96271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP706) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-09-24 |