| NPI | 1215083191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-5040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 39210) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2025-02-27 |