NPI | 1871654913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD024973E) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD024973E) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2021-04-01 |