| NPI | 1275514218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 3984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 35299) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2026-05-05 |