| NPI | 1407823925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME108474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 32971) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-09-02 |