| NPI | 1306323266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD474939) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT214899) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2021-07-26 |