| NPI | 1598803470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME102281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 211338) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-03-29 |