| NPI | 1063851103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD455986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205206) |
| 207R00000X Internal Medicine (Licence: TN 54131) | |
| 207R00000X Internal Medicine (Licence: OR MD211376) | |
| 208M00000X Hospitalist (Licence: TN 54131) | |
| 208M00000X Hospitalist (Licence: OR MD211376) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-09-07 |