| NPI | 1801887278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD040177) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200501641) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2019-08-08 |