| NPI | 1205895802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0062108) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD424855) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2024-11-05 |