| NPI | 1518276146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME114208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 28250) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2023-05-24 |