| NPI | 1396000287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.150745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-202443) |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2019-10-01 |