| NPI | 1003591835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV SL2024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A24581) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2025-09-09 |