| NPI | 1417528134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-54644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 9161) |
| Enumeration Date | 2021-07-03 |
| Last Update Date | 2025-06-17 |