| NPI | 1740498146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME107167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD437454) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-10-23 |