| NPI | 1265124283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.180360) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023019402) |
| 207R00000X Internal Medicine (Licence: WI 87085-20) | |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2026-07-10 |