| NPI | 1033311121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 049028) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: CT 049028) |
| 207R00000X Internal Medicine (Licence: PA MD437241) | |
| 208M00000X Hospitalist (Licence: PA MD437241) | |
| 208M00000X Hospitalist (Licence: CT 049028) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-12-09 |