| NPI | 1922158542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD450634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 62385) |
| 207R00000X Internal Medicine (Licence: NJ MA66667) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2019-03-20 |