| NPI | 1689746166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101055858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0072076) |
| 207R00000X Internal Medicine (Licence: DC MD039289) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-05-27 |