| NPI | 1467890335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD459538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205120) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-09-20 |