| NPI | 1134442213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-126036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT191660) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2011-02-10 |