| NPI | 1316153539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 259899) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: NY 259899) |
| 208M00000X Hospitalist (Licence: NY 259899) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT190397) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-07-06 |