| NPI | 1174028286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0091160) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D0091160) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D0091160) | |
| 207RH0005X Internal Medicine, Hypertension Specialist (Licence: MD D0091160) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-09-29 |