| NPI | 1043278385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD030928E) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: PA MD030928E) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-03-07 |