| NPI | 1831627843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD210001428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070562) |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2024-09-09 |