| NPI | 1356662795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD448809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197200) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2023-08-15 |