| NPI | 1265451678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD013907E) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD013907E) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD013907E) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-08-21 |