| NPI | 1043617830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD458314) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 20143) |
| 207R00000X Internal Medicine (Licence: PA MD458314) | |
| 207RH0003X Internal Medicine Hematology & Oncology (Licence: PA MT224767) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2025-06-11 |