| NPI | 1568484004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: PA OS-0100000-L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS010000-L) |
| 208M00000X Hospitalist (Licence: PA OS010000L) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-01-11 |