| NPI | 1417985318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0035685) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME98136) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-12-04 |