| NPI | 1700824232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME88351) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 68351) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-11-02 |