| NPI | 1255396776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI KF014353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101014353) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2026-04-24 |