| NPI | 1275847949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 64896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102420) |
| 202K00000X Phlebology (Licence: CT 64896) | |
| 208M00000X Hospitalist (Licence: CT 64896) | |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2025-09-22 |