| NPI | 1063519353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 046113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD88605) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-12-18 |