| NPI | 1528264686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2007014951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118133) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2025-12-18 |