| NPI | 1427084888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME80234) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0080234) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2021-09-03 |