| NPI | 1316916208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD049769L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD049769L) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-07-31 |