| NPI | 1821236357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101260163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD039873) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2025-03-17 |