| NPI | 1699209882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME144145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD17059) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-01-24 |