| NPI | 1437509221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD467316) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT210879) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2019-07-17 |