| NPI | 1528084050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD-025202-E) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD-025202-E) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD-025202-E) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2014-05-21 |