| NPI | 1295795771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01065572A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 27240) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2025-03-08 |