| NPI | 1285259606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD481015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT220153) |
| 207R00000X Internal Medicine (Licence: GA 14834) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2024-02-12 |