| NPI | 1538471784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS016734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013387) |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2020-09-26 |