| NPI | 1366776742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD446780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD446780) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2025-09-12 |