| NPI | 1588234140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A196583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8096) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2025-01-10 |