| NPI | 1952472920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A41357) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2026-08-21 |