| NPI | 1225002066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 70456) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 70456) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2025-02-06 |