| NPI | 1295072866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD227643) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015014082) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2026-01-21 |