| NPI | 1770534075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: PA MD427961) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD427961) |
| 207P00000X Emergency Medicine (Licence: PA MD427961) | |
| 207P00000X Emergency Medicine (Licence: NY 273809) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-03-07 |