| NPI | 1447466446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 066499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME103776) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2016-04-14 |