| NPI | 1548204985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD019369E) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 34994) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G47355) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-09-17 |