| NPI | 1588616908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101242578) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 83820) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-09-22 |