| NPI | 1427585835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT212649) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470700) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2020-08-04 |