| NPI | 1114993227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD041440L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD041440L) |
| 2080C0008X Pediatrics Child Abuse Pediatrics (Licence: PA MD041440L) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2025-07-30 |