| NPI | 1336331214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 21755) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A12429) |
| 207R00000X Internal Medicine (Licence: CA 20A12429) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2025-10-09 |