| NPI | 1437444221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-02094) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME117523) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2015-03-24 |