| NPI | 1598051328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0077432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME157528) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-09-28 |