| NPI | 1538278726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101285444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 037027) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-08-05 |