| NPI | 1508020587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 269660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD038962) |
| 207R00000X Internal Medicine (Licence: MD D0071774) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2019-04-10 |