| NPI | 1083879985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C10010362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188795) |
| 207R00000X Internal Medicine (Licence: PA MD435532) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-06-30 |