| NPI | 1053671529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 50196) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT201636) |
| 208M00000X Hospitalist (Licence: AZ 50196) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2022-03-28 |