| NPI | 1114363819 |
|---|---|
| Other Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: PA MD462195) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0082420) |
| 208M00000X Hospitalist (Licence: MD D0082420) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2023-10-25 |