| NPI | 1063427532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2025-02647) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 38676) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: SC 38676) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-08-27 |