| NPI | 1750490702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C42157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 3987) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-05-05 |