| NPI | 1346205200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD29133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 215790) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2025-03-05 |