| NPI | 1891291878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD482088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 85931) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2023-11-07 |