| NPI | 1346315157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0047153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D47153) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-07-21 |