| NPI | 1922070622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD020707E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD020707E) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2007-11-02 |