| NPI | 1609082064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD435403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 21686) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-08-07 |