| NPI | 1285691279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD-043784-L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35061137) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-08-22 |