| NPI | 1336250828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 83989) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-10625) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-06-10 |