| NPI | 1336383215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD444032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194635) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2012-07-30 |