| NPI | 1730578683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD049319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125068716) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2023-09-25 |