| NPI | 1013296292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD452182) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MT 198779) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2021-05-25 |