| NPI | 1316496847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102205404) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116029972) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2026-02-25 |