| NPI | 1356736763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: DC MD045987) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD045987) | 
| Enumeration Date | 2015-04-02 | 
| Last Update Date | 2024-03-26 |