| NPI | 1275037939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS17765) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 330560) |
| 207R00000X Internal Medicine (Licence: MS 33988) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-10-16 |