| NPI | 1245751825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.43830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT212503) |
| Enumeration Date | 2017-07-04 |
| Last Update Date | 2022-06-27 |