| NPI | 1134859242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-54491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-12649) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2025-07-07 |