| NPI | 1134292493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-00866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0042033) |
| 207R00000X Internal Medicine (Licence: DC MD19316) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-09-24 |