| NPI | 1265446868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2014-00297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD 038177 E) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-01-25 |