| NPI | 1073977542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD047156) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101266600) |
| 207R00000X Internal Medicine (Licence: AZ R75469) | |
| 207R00000X Internal Medicine (Licence: MD D0087094) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2021-06-26 |