| NPI | 1619957396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD-052101-L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 98-00074) |
| 207P00000X Emergency Medicine (Licence: PA MD052101L) | |
| 207P00000X Emergency Medicine (Licence: OH 35-066777) | |
| 207P00000X Emergency Medicine (Licence: NY 208218-1) | |
| 207R00000X Internal Medicine (Licence: NC 98-00074) | |
| 207R00000X Internal Medicine (Licence: OH 35-066777) | |
| 207R00000X Internal Medicine (Licence: NY 208218-1) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2012-02-14 |