| NPI | 1205284437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD471298) |
| Additional Taxonomies | 202K00000X (Licence: PA MD471298) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2024-06-26 |