| NPI | 1548535735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301507370) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 272840) |
| 207R00000X Internal Medicine (Licence: VA 0101260465) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-06-13 |