| NPI | 1619915527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD443377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301083048) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2023-04-04 |