| NPI | 1992750186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD056047L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD056047) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-03-11 |