| NPI | 1013915743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD036890E) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: PA MD036890E) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-04-25 |