| NPI | 1528406725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 74891) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-10-18 |