| NPI | 1134482383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS017688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS017688) |
| 207R00000X Internal Medicine (Licence: PA OT-014610) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-02-05 |