| NPI | 1023490430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD464244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT208058) |
| 207R00000X Internal Medicine (Licence: AL 40795) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2023-07-11 |