| NPI | 1356662431 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PA MD061074L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD061074L) |
| Enumeration Date | 2010-06-12 |
| Last Update Date | 2023-10-02 |