| NPI | 1396794400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD020590E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 020590E) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2022-05-26 |