| NPI | 1518292606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME114253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125053885) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2018-01-02 |