| NPI | 1831451442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD26792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202336) |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2023-07-11 |