| NPI | 1689781791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 40642-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD195582) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2026-03-06 |