| NPI | 1033371752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0087213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204216) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2026-01-13 |