| NPI | 1003433608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0100020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD210011466) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2025-05-05 |