| NPI | 1497872402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 48970) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD437639) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-11-29 |