| NPI | 1477716371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD449039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0009731) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2013-12-13 |