| NPI | 1821434556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101260961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD044610) |
| 207R00000X Internal Medicine (Licence: MD D82314) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2021-06-06 |