| NPI | 1952369548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD471851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101275199) |
| 207R00000X Internal Medicine (Licence: NY 223349) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-01-23 |