| NPI | 1922031608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME128926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 18237) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-02-06 |