| NPI | 1649437120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0069221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD037208) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-06-23 |