| NPI | 1225193543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD432810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT186304) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2012-05-21 |