| NPI | 1396278206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01097275A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101267718) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-07-21 |