| NPI | 1730351867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD441286) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 002560) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2016-07-19 |