| NPI | 1215370069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD042796) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D81500) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2021-06-21 |