| NPI | 1942485321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0068890) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD432933) |
| 282N00000X General Acute Care Hospital (Licence: MD D0068890) | |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MD D0068890) | |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2025-07-07 |