| NPI | 1518093426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD32485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101229279) |
| 207R00000X Internal Medicine (Licence: MD D0055354) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2022-02-08 |