| NPI | 1518993443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD462962) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06090600) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-03-04 |