| NPI | 1134198757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD031317E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D73225) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-12-18 |