| NPI | 1063412641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD048473L) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD048473L) |
| 208000000X Pediatrics (Licence: PA MD048473L) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2023-03-07 |