| NPI | 1619262847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0080724) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD043744) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2016-01-19 |