| NPI | 1093980518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD440887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD440887) |
| 208D00000X General Practice (Licence: IN 01063004A) | |
| 208D00000X General Practice (Licence: NY 247133) | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2024-10-30 |