| NPI | 1952458101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME69302) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME69302) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2026-06-22 |