| NPI | 1356696348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS013631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 292132) |
| 207Q00000X Family Medicine (Licence: PA MD466748) | |
| 208M00000X Hospitalist (Licence: PA MD466748) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2024-09-17 |