| NPI | 1467598755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD037404-L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD037404L) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2025-05-08 |