| NPI | 1093001240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005132A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019101) |
| 207R00000X Internal Medicine (Licence: AL DO.1607) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2025-04-15 |