| NPI | 1104209147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 82807) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD4644393) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2024-01-03 |