| NPI | 1962472696 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD423203) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD423203) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-12-26 |