| NPI | 1114338993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2019-01501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT015725) |
| 207R00000X Internal Medicine (Licence: NC 2019-01501) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2023-01-10 |