| NPI | 1952838344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H89746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS019623) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2024-08-16 |