| NPI | 1720473960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0084897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101264105) |
| 207R00000X Internal Medicine (Licence: DC MD046134) | |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2021-06-27 |