| NPI | 1205834603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD043600L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06014500) |
| 207R00000X Internal Medicine (Licence: PA MD043600L) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-02-05 |