| NPI | 1699736439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD019490E) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: PA MD019490E) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2015-07-01 |