| NPI | 1497739015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 96251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 68691) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2026-03-02 |