| NPI | 1063441954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD037522E) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: PA MD037522E) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-07-30 |