| NPI | 1861557043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD13778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101037057) |
| 207R00000X Internal Medicine (Licence: MD D0031124) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2011-11-09 |