| NPI | 1265524771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1021922) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036085210) |
| 207R00000X Internal Medicine (Licence: NH EL11189) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2026-06-17 |