| NPI | 1679834428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD484963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 252285) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2024-09-21 |