| NPI | 1548720279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD482126) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A177467) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-06-29 |