| NPI | 1922193853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 26352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME64338) |
| 207R00000X Internal Medicine (Licence: MS 14182) | |
| 207R00000X Internal Medicine (Licence: PA MD053776L) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2025-09-11 |