| NPI | 1285928358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT199612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101278336) |
| 207R00000X Internal Medicine (Licence: TN 67893) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-02-20 |