| NPI | 1538232723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0050209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD22160) |
| 207R00000X Internal Medicine (Licence: VA 0101059128) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-12-03 |