| NPI | 1427254283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME117949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 44152) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-10-02 |