| NPI | 1467472449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME101120) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 171223) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-04-10 |