| NPI | 1124244108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD433586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00075) |
| 207R00000X Internal Medicine (Licence: PA MD433586) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2017-04-21 |