| NPI | 1619046976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD 18463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D 40102) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2023-08-09 |