| NPI | 1821008517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD16443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 16443) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-04-14 |