| NPI | 1225455389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD500002502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD464150) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2025-01-06 |