| NPI | 1467834499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 80896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 31609) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2025-11-06 |