| NPI | 1689735144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D41747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD21652) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2023-02-16 |