| NPI | 1518961150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0054277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD035761) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2025-02-27 |