| NPI | 1528282167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME101960) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 258510) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2023-10-27 |