| NPI | 1891942645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024007591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A112877) |
| 207R00000X Internal Medicine (Licence: NY 2581181) | |
| Enumeration Date | 2008-08-23 |
| Last Update Date | 2025-03-13 |