| NPI | 1497750764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD16477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 016477) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2023-11-03 |