| NPI | 1609307404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 94078) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 94078) |
| 207R00000X Internal Medicine (Licence: MA 281458) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MA 281458) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2026-05-18 |