| NPI | 1730142951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME48901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0048901) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-08-30 |