| NPI | 1194354399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 96516) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A187252) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-07-06 |