| NPI | 1336345263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD166846) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-15536) |
| 207R00000X Internal Medicine (Licence: CA A105728) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-08-21 |