| NPI | 1396932356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME71176) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 0071176) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2024-11-01 |