| NPI | 1437130473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 213352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH EL03407) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-05-13 |