| NPI | 1285897868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D74816) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13150) |
| 207R00000X Internal Medicine (Licence: PA MD434776) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-10-13 |