| NPI | 1134389471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD043763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101781) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2016-07-14 |