| NPI | 1255409686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD32022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D56516) |
| 207R00000X Internal Medicine (Licence: VA 0101230282) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-10-22 |