| NPI | 1003101908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT200230) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 37780) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D85999) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-08-24 |