| NPI | 1215918990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD025295E) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD025295E) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2008-07-16 |