| NPI | 1750848693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD0015115E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD015115E) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |