| NPI | 1528656170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT227888) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446664) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2023-05-10 |