| NPI | 1154392959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A117157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-13621) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2026-01-11 |