| NPI | 1699708222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME107361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A90121) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-05-14 |