| NPI | 1730234030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 82722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239038) |
| 207R00000X Internal Medicine (Licence: DC MD034363) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2019-10-29 |