| NPI | 1265774426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD483420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV LL2756) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-03-27 |