| NPI | 1447403746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME122066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055226) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2022-10-17 |