| NPI | 1245398866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101237383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0072216) |
| 207R00000X Internal Medicine (Licence: DC MD31727) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-06-09 |