| NPI | 1235361007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101259479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0074856) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2025-03-19 |