| NPI | 1295734234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD035898) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0058922) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-08-16 |