| NPI | 1568548790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 075176) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 19536) |
| 207R00000X Internal Medicine (Licence: IN 01076261A) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2025-03-26 |