| NPI | 1831320639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD037969) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2017-01-25 |