| NPI | 1457594319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD446219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194751) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2012-07-18 |