| NPI | 1710100177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0051327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD21818) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2023-07-19 |