| NPI | 1609913532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D80848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD30375) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2024-05-22 |