NPI | 1295771954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD035836L) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD035836L) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2022-09-26 |