| NPI | 1235557208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD045159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A138344) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-07-21 |