| NPI | 1437545662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME169261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 55753) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2024-08-22 |