| NPI | 1770514507 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS011175L)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS011175L)  | 
| 207R00000X Internal Medicine (Licence: PA OS011175L)  | |
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2007-10-02 |