| NPI | 1013357268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS018866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013021411) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2024-02-16 |