| NPI | 1770143067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0094575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019019484) |
| 207R00000X Internal Medicine (Licence: DC MD210002478) | |
| 207R00000X Internal Medicine (Licence: VA 0101275351) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-07-31 |