| NPI | 1982634283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 044286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME101668) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-09-30 |