| NPI | 1992962179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD038979) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0070501) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2020-10-19 |