| NPI | 1518257856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09671900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD446648) |
| 208M00000X Hospitalist (Licence: PA MD446648) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2024-09-03 |