| NPI | 1639335367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD462644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-098744) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.098744) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.098744) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2022-07-21 |