| NPI | 1366518540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D60658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101248802) |
| 207R00000X Internal Medicine (Licence: DC MD34367) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-11-18 |