| NPI | 1487278909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 4115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 96084) |
| 207R00000X Internal Medicine (Licence: GA 11874) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-07-23 |