| NPI | 1093729972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2009029460) | 
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: KY 39466) | 
| 207R00000X Internal Medicine (Licence: KY 39466) | |
| Enumeration Date | 2006-07-28 | 
| Last Update Date | 2023-10-26 |