| NPI | 1619041043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME159613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 53002) |
| Enumeration Date | 2006-11-18 |
| Last Update Date | 2024-11-01 |