| NPI | 1780785402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME156236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036088924) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-11-16 |