| NPI | 1124213335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD459225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD459225) |
| 207R00000X Internal Medicine (Licence: NC 2007-01222) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2022-08-29 |