| NPI | 1952372179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME120993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 047494) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2015-07-20 |