| NPI | 1881653657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD432045) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 37314) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2021-11-29 |