| NPI | 1275733818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 232398) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD039914) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2013-02-25 |