| NPI | 1780909556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD044384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60367274) |
| 207R00000X Internal Medicine (Licence: VA 0101261586) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-11-16 |