| NPI | 1518985639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD026339E) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0009464) |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: PA MD026339E) | |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD026339E) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-07-18 |