| NPI | 1245470327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2024-03627) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD443259) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2025-01-09 |