| NPI | 1972534592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD18527) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0033588) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-11-16 |