| NPI | 1457304396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D77814) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 40592) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-06-12 |