| NPI | 1316432297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD475573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT216870) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2021-09-10 |