| NPI | 1073076642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD210012139) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0098355) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-10-30 |