| NPI | 1720044241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME92546) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL ME92546) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2014-08-25 |