| NPI | 1215420708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD210002072) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072082) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-06-01 |