| NPI | 1023163128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD32366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D57310) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2021-06-27 |