| NPI | 1770550147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD457071) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06069400) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2020-05-21 |