| NPI | 1699083154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D72380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD441237) |
| 207P00000X Emergency Medicine (Licence: NH LT4311) | |
| 207R00000X Internal Medicine (Licence: PA MD441237) | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2022-02-07 |