| NPI | 1134288053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD-056348-L) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD-056348-L) |
| 208D00000X General Practice (Licence: PA MD-056348-L) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2024-02-13 |