| NPI | 1427407253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA md61070467) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301110287) |
| 207R00000X Internal Medicine (Licence: FL ME143089) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2020-11-02 |