| NPI | 1003000126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101254037) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0000290) |
| 207R00000X Internal Medicine (Licence: MD D0068455) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2021-02-12 |