| NPI | 1235496340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: PA MD456181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD456181) |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: PA MD456181) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2022-09-20 |