| NPI | 1467479022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD25308) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 12147) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-08-23 |