| NPI | 1417012691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101233842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD34027) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2021-11-30 |