| NPI | 1851540454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD028050L) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD028050L) |
| 208600000X Surgery (Licence: PA MD028050L) | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2020-01-17 |