| NPI | 1437167434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME134602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 043720) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2021-08-26 |