| NPI | 1902037476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME154177) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A070202) |
| Enumeration Date | 2009-08-01 |
| Last Update Date | 2022-01-14 |