| NPI | 1366407165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD023228E) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD023228E) |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MD023228E) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2010-07-12 |