| NPI | 1013134469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD431085) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KS 0431207) |
| 208D00000X General Practice (Licence: MN 47001) | |
| 208M00000X Hospitalist (Licence: PA MD431085) | |
| 207R00000X Internal Medicine (Licence: IA 39580) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-01-22 |