| NPI | 1528153160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD043764) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R8G21) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-03-31 |