| NPI | 1023067378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 41113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 117798) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2025-02-20 |