| NPI | 1326257262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME105675) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190591) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-08-01 |