| NPI | 1104198910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD456478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 56762) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2019-11-06 |