| NPI | 1689316515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.48224) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 48224) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2025-11-28 |