| NPI | 1073588067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD034548E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD034548E) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2012-02-29 |