| NPI | 1750735262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD470587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470587) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2024-06-28 |