| NPI | 1437133121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 38836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01056286A) |
| 207R00000X Internal Medicine (Licence: FL ME122430) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2023-07-11 |