| NPI | 1578541165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD035609E) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD035609E) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2013-02-06 |