| NPI | 1053417485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD425621) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD425621) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD425621) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-08-15 |