| NPI | 1922088426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD217629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0005236) |
| 207R00000X Internal Medicine (Licence: DE C1-0005236) | |
| 207R00000X Internal Medicine (Licence: DE 179283) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-10-31 |