| NPI | 1417911587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD041450E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PW MD-041450E) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-07-06 |