| NPI | 1710513726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD30216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A185239) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-03-05 |