| NPI | 1598720823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD461205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01029173A) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-07-21 |