| NPI | 1649212978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101230403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0055635) |
| 207R00000X Internal Medicine (Licence: DC MD31691) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |