NPI | 1912130584 |
---|---|
Former Name | TWANA H FARAJ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101251210) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01628) |
207R00000X Internal Medicine (Licence: TN 65527) | |
Enumeration Date | 2009-08-31 |
Last Update Date | 2022-08-31 |