| NPI | 1427685767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A201693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1013382) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-08-08 |