| NPI | 1982983557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C169910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042-0013045) |
| 207R00000X Internal Medicine (Licence: DE C1-0027668) | |
| 207R00000X Internal Medicine (Licence: PA MD457651) | |
| 207R00000X Internal Medicine (Licence: MA 249727) | |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2025-01-13 |