| NPI | 1437304813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD032452L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD 032452L) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |