| NPI | 1285702605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0018137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101026951) |
| 207R00000X Internal Medicine (Licence: DC MD034694) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-11-26 |