| NPI | 1548440860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME101456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 07865) |
| 207R00000X Internal Medicine (Licence: AL MD35021) | |
| 207R00000X Internal Medicine (Licence: ME MD19073) | |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2025-07-21 |