| NPI | 1275682320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D58844) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD33758) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-10-16 |