| NPI | 1447281308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0064651) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D64651) |
| 208D00000X General Practice (Licence: MD D64651) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-10-05 |