| NPI | 1083741433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PA MD442953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-228192) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2016-03-24 |