| NPI | 1598740359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301075537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD417205) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-05-10 |