| NPI | 1881648798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD062628L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44582) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2012-10-03 |