| NPI | 1588893036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086519A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 113981) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2023-04-13 |