| NPI | 1043534530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD470852) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101253856) |
| 207R00000X Internal Medicine (Licence: VA 0101253856) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2021-02-11 |