| NPI | 1831289115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 50521) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C146438) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2026-02-09 |