| NPI | 1588899348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME116463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 32042901) |
| 207R00000X Internal Medicine (Licence: MI 4301094878) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2024-06-01 |