| NPI | 1750638243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME113826) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME113826) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2021-02-03 |