| NPI | 1881652618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 77908) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MA 77908) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2011-04-28 |