| NPI | 1548292063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD052613L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 82142) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-01-17 |