| NPI | 1124047568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101271389) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 30897) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-02-13 |