| NPI | 1003000407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS012940) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS012940) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2020-05-14 |