| NPI | 1942415716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD439980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD439980) |
| 208000000X Pediatrics (Licence: PA MD439980) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2013-04-16 |