| NPI | 1568754786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD482481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0079010) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2023-08-24 |