| NPI | 1366708810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD045381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD453758) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2022-07-21 |