NPI | 1316943087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD010182E) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD010182E) |
Enumeration Date | 2005-06-27 |
Last Update Date | 2021-01-29 |