| NPI | 1447579388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD447842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D76044) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2017-08-08 |