NPI | 1487806402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD441934) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD441934) |
Enumeration Date | 2008-10-22 |
Last Update Date | 2020-10-05 |