| NPI | 1629208095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME DO2558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS12299) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2019-03-11 |