| NPI | 1487854337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101235624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD036206) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |