| NPI | 1447363452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 54481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-18784) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-02-22 |