| NPI | 1902866510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD035175L) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD035175L) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2012-08-10 |