| NPI | 1841450343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD437553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188468) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2010-04-12 |