| NPI | 1558408021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0054508) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD31537) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2017-11-11 |