| NPI | 1124307988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD468326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 262421) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2019-08-12 |