| NPI | 1184109209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01096253A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301512355) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2025-06-20 |