| NPI | 1831259423 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D32247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD15906) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2025-01-30 |