| NPI | 1104565423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD487971) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD487971) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2026-01-16 |