| NPI | 1730193301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D23556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD11648) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-05-18 |