| NPI | 1942225396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD21216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D42105) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-07-11 |