| NPI | 1841446135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD436644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188563) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2020-08-05 |