| NPI | 1568434041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD429901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT 9788) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2011-06-07 |