| NPI | 1386612372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 016900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD16900) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2025-07-31 |