| NPI | 1407238264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 75926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD046359) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2023-10-09 |