| NPI | 1326250705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD036623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0086027) |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2025-10-28 |