| NPI | 1831355486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD040057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116020899) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2021-12-17 |