| NPI | 1609091081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0039855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 0039855) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2011-06-16 |