| NPI | 1881969194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD045488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 053824) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-09-08 |