| NPI | 1235571274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.32638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 70762) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2025-05-08 |