| NPI | 1407941255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME138841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036066875) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-10-17 |