| NPI | 1235427246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS016313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA FF1190747) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2023-03-07 |