| NPI | 1518043108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0068874) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0068874) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2016-11-22 |