| NPI | 1265491070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D00053210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD31363) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-01-27 |