| NPI | 1427389766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS018487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 2512) |
| 207R00000X Internal Medicine (Licence: NE 861) | |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2019-07-16 |